Need your advise ...

[Crickie]

Hello, I've posted here before.

I'm really at a loss and need advice ...

I've done several chemos for ovc recurrence without success. Last week I was told that surgery is my only option. I would need a colostomy. I'm 45 and feel that before I agree to such a drastice, altering surgery I want to explore further chemos. My chemo doctor wants me to stop chemo and 'live my life' with no further treatment. My tumor is growing and I'm told within 6 months I'll need a 'bag' for palliative reason. I was also told that my cancer is chemo resistant. I've tried several combinations and sole treatments like carbo/taxol,taxol alone, doxil, gemzar, etc. My tolerance of these chemos has not been good.

My question is: how long does one have to wait after chemo to have surgery (is there a waiting period?)

I would like to try another chemo (maybe topectan?) to see if it would work to shrink. If it wouldn't work in 3 months, would I still be able to have surgery right after? Why are all my doctors giving up on me and chemo and are quick to tell me to have this surgery?

I'm scared, confused and running out of time. Please help.

[Crickie]

The reason for the permanent colostomy is your #2 - they're pretty sure there won't be any rectum left after tumor removal to reconnect intestine. I feel this is too drastic a surgery without persuing any other chemo.

The doctors (I have three who tell me the same thing) say that since first line chemo never worked on me and I tried two second line chemos, and they didn't work, that persuing another chemo would only keep the tumor growing and by 6 months the tumor would be so big it would not allow any bowel movements and press on my kidneys, etc... I'd need a bag for palliative reasons.

I'd like to try topotecan for 3 months or I remember reading that sometimes first line works after 6 months? Or did I get this wrong?  If the topetecan wouldn't work I'd rebuild my stregth for a month or two and THEN have the surgery. Doctors says that I'm playing with time ....

I have no other spread of cancer -it's all in the pelvis. I'm not mentally ready for this surgery and no one wants to give me another alternative. Can you?

[Annekathryn Goodman, M.D.]

Dear Crickie,


Without examining you and seeing your x rays, I can only address your important questions  general terms.

A colostomy means bringing a section of the large intestine to the skin of the abdomen and putting a bag over it. It means that the bowel movements will now go into the bag and a person will not longer have a normal bowel movement.

Reasons for colostomy:

-if there is a blockage in the larger intestine and it is not possible to remove the area of blockage, a colostomy diverts the stool from the area of the blockage

-if a large portion of the large intestine is removed and it is not possible to recconnect the bowel because there is not enough anus /rectum left, one needs a permanent colostomy.


If it has been suggested to you that the only option is surgery, it may be that you are in some danger from a blockage in your bowel. If there is a blockage in the bowel, the bowel in the area before the blockage will get swollen. At some point, if the bowel gets too swollen, there is a risk or rupture of the bowel or perforation. That is a life threatening emergency.

You should ask your doctor if you are in danger and if perforation is a risk.

If so, you should strongly consider a colostomy and then take more chemotherapy.

Unless it is an emergency and surgery is necessary immediately, it is important to wait until the blood counts are up after chemo before surgery.

It must feel very lonely to feel that your doctors are giving up. Ask them what is going on.
please keep me posted
take care